Negative life events and migraine: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data

Abstract

BackgroundStress is a typical migraine trigger. However, the impact of negative life events on migraine activity is poorly studied. The aim of this study is to investigate the association between negative life events and migraine using data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment.MethodsELSA-Brasil is a multicenter cohort study conducted in six Brazilian cities. Baseline assessment included validated questionnaires for headache classification and the occurrence of five pre-specified negative life events (financial hardship, hospitalization other than for childbirth, death of a close relative, robbery and end of a love relationship), focusing on a 12-month period before evaluation. We built crude and adjusted logistic regression models to study the association between the occurrences of negative life events and migraine diagnosis and activity.ResultsWe included 4,409 individuals with migraine and 4,457 participants without headache (reference). After adjustment for age, sex, race, income and educational level, we found that the occurrence of a negative life event (Odds ratio = 1.31; 95% confidence interval = 1.19 – 1.45) was associated with migraine. However, after stratifying with subgroup analyses, only financial hardship (Odds ratio = 1.65; 95% confidence interval = 1.47 – 1.87) and hospitalization (Odds ratio = 1.47; 95% confidence interval = 1.25 – 1.72) were independently associated with migraine. Further adjustment for a current major depression episode and report of religious activity did not significantly change the results. Considering migraine frequency as (a) less than once per month, (b) once per month to once per week, or (c) more than once per week, financial hardship and hospitalization remained significantly associated with migraine in all episode frequency strata, with higher odds ratios for higher frequencies in adjusted models. We also observed a significant association between the death of a close relative and the highest migraine frequency stratum (Odds ratio = 1.38; 95% confidence interval = 1.09 – 1.75) in full-adjusted model.ConclusionsThe occurrence of financial hardship and hospitalization had a direct and independent association with migraine diagnosis and frequency. The death of a close relative was also independently associated with the highest migraine frequency stratum.

Work‐family conflict, lack of time for personal care and leisure, and job strain in migraine: Results of the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil)

“…Participants who reported experiencing headache in the last 12 months at baseline were invited to answer a detailed headache questionnaire based on the International Headache Society criteria (IHS‐2013), adapted for the Brazilian Portuguese language. This questionnaire has been validated and used previously in Brazil [Santos et al, ,]. The questionnaire investigates pain frequency, duration, quality, location, intensity, and triggering, as well as accompanying symptoms, such as nausea or vomiting [Santos et al, ].…”

Migraine and its psychiatric comorbidities

“…The Frequent Headache Epidemiology Study suggested that patients with CM had more major life events in the year preceding the chronification of their migraines than did patients with EM 31. The Longitudinal Brazilian study (ELSA-Brasil) showed an association between negative life events and increased frequency of migraine 32. Stress management with relaxation therapies, biofeedback and cognitive behavioural therapies were proven to be effective migraine prophylaxis measures 33–37…”

Life With Migraine: Effects on Relationships, Career, and Finances From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study

“…Globally, migraine is also associated with variable but substantial negative personal impacts on education, career, and finances . A cross‐sectional study conducted in multiple headache centers in Austria demonstrated that approximately 34% of respondents, most of whom had episodic (56.4%) or chronic headache (38.3%), reported that their headaches had a negative impact on their careers and 21.5% reported a negative impact on earnings.…”